Senior Data Analyst - Healthcare Claims Fraud Detection

About The Company

UnitedHealthcare, a leading division of UnitedHealth Group, is dedicated to transforming the healthcare experience by creating healthier communities and removing barriers to access and quality care. As a Fortune 6 organization, UnitedHealthcare leverages innovation, data-driven insights, and a patient-centric approach to improve health outcomes for millions of individuals across the United States. The company emphasizes inclusivity, diversity, and a commitment to equitable healthcare, striving to address disparities and promote health equity for all populations. With a focus on operational excellence and strategic growth, UnitedHealthcare continuously seeks talented professionals to join its mission of making healthcare more affordable, responsive, and accessible.

About The Role

We are seeking a detail-oriented and analytical Data Analyst to join our team. In this role, you will play a vital part in monitoring patterns of potential fraud, waste, and abuse within healthcare claims data to ensure compliance with legal and contractual obligations. You will collaborate closely with investigations teams, support data collection activities, and generate routine and ad-hoc reports for regulatory and executive stakeholders. Your expertise will help identify trends, uncover opportunities for process improvements, and support the overall integrity of our healthcare operations. This position offers flexibility to work remotely from anywhere within the U.S., with the exception of certain locations where in-office presence is required. The role requires a proactive mindset, strong communication skills, and the ability to translate complex data insights into meaningful recommendations.

Qualifications

• Bachelor's Degree in a related field such as Data Science, Statistics, Healthcare Administration, or equivalent.
• Minimum of 2+ years of experience supporting healthcare claims environments or related projects.
• At least 1+ years of experience with VBA (Visual Basic for Applications).
• At least 1+ years of experience with SAS and/or SAS Enterprise Guide.
• Proficiency in creating and utilizing data modeling tools, spreadsheets, and information acquisition tools.
• Strong communication skills, capable of explaining complex data findings to non-technical audiences via phone and email.
• Advanced proficiency in MS Excel, including formulas, pivot tables, macros, lists, and statistical functions.
• Intermediate proficiency in MS Office Suite (Word, PowerPoint, Outlook).

Responsibilities

• Perform comprehensive data analysis and extraction activities to support investigation efforts, including data summaries, sampling, and special projects.
• Prepare healthcare claims data for investigative purposes and collaborate with investigation teams to understand data content and insights.
• Establish, implement, and maintain standard policies, procedures, and best practices to ensure compliance with applicable laws and contractual obligations.
• Support data collection activities for the Special Investigations Unit (SIU) and generate routine reports for regulatory agencies and executive leadership.
• Create, publish, and distribute scheduled and ad-hoc reports related to product performance, operational metrics, and technological developments.
• Analyze data to identify trends, patterns, and opportunities that can enhance business processes and client outcomes.
• Communicate research findings effectively to internal teams, clients, and external stakeholders, ensuring clarity and actionable insights.
• Maintain accuracy and integrity of data analysis processes, adhering to company policies and industry standards.

Benefits

• Competitive salary package, ranging from $58,800 to $105,000 annually, based on experience and qualifications.
• Comprehensive health, dental, and vision insurance plans.
• Retirement savings options including 401(k) contributions.
• Incentive and recognition programs to reward outstanding performance.
• Equity stock purchase opportunities.
• Flexible remote work arrangements, promoting work-life balance.
• Professional development programs and career growth opportunities.
• Paid time off and holidays to support personal well-being.

Equal Opportunity

UnitedHealth Group is an Equal Employment Opportunity employer. We are committed to creating an inclusive environment where all employees and applicants are treated with respect and dignity. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other characteristic protected by applicable laws.